Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.71 / $133.38 / $133.38	Professional		$86.71	$133.38	$133.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.75 / $44.45 / $45.29	Professional	26	$32.75	$44.45	$45.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.96 / $88.93 / $88.93	Professional	TC	$53.96	$88.93	$88.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.86 / $194.03 / $274.39	Professional		$48.86	$194.03	$274.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.44 / $68.67 / $97.11	Professional	26	$17.44	$68.67	$97.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.42 / $125.36 / $177.28	Professional	TC	$31.42	$125.36	$177.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.03 / $122.06 / $335.41	Professional		$61.03	$122.06	$335.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $42.25 / $116.10	Professional	26	$21.12	$42.25	$116.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.90 / $79.81 / $219.31	Professional	TC	$39.90	$79.81	$219.31
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $128.49 / $174.39 / $396.58	Professional		$128.49	$174.39	$396.58
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $46.29 / $62.82 / $142.87	Professional	26	$46.29	$62.82	$142.87
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $82.21 / $119.20 / $253.74	Professional	TC	$82.21	$119.20	$253.74
United Facility/Professional Professional Modifier Low / Median / High Price $79.89 / $133.15 / $233.15	Professional		$79.89	$133.15	$233.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.23 / $47.05 / $164.70	Professional	26	$28.23	$47.05	$164.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $98.34 / $260.10	Professional	TC	$59.00	$98.34	$260.10
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $126.68 / $191.94	Professional		$104.55	$126.68	$191.94
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $35.01 / $48.17 / $66.31	Professional	26	$35.01	$48.17	$66.31
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $66.33 / $79.59 / $117.01	Professional	TC	$66.33	$79.59	$117.01